摘要
目的探讨医源性胆道损伤的原因及防治措施。方法回顾性分析28例医源性胆管损伤病人的临床资料。结果仅行缺损修补及Winslow孔引流3例;修补后加T管支撑引流5例;胆总管端端吻合加T管支撑4例;胆总管十二指肠端侧吻合术2例;胆管空肠Roux-en-Y吻合术14例。术后8例感染患者经抗感染、保肝及全身支持治疗后痊愈;13例带管者T管于术后6～12月顺利拔出,2例后期再次出现胆道狭窄,行胆总管空肠Roux-en-Y吻合术后治愈。结论医源性胆道损伤是胆囊切除术常见的严重并发症,一旦发现,应及时处理,根据损伤的情况和术后时间选择不同的方法。
Objective To investigate the common causes and prevention measures for iatrogenic bile injury.Methods Clinic data of 28 patients with iatrogenic bile injury were analyzed.Result 3 cases only repaired defect with drainage in Winslow hole,while using T tube for support 5 cases.End to end anastomosis of common bile duct with T tube support in 4 cases,end to side anastomosis of common bile duct and duodenum in 2 cases and bile duct jejunum Roux-en-Y anastomosis in 14 cases.8 cases with infection recovered after anti-infection liver and body support.13 cases with T tube for support were extracted 6 to 12 months after operation.Late recurrence of biliary stricture happened in 2 cases were healing after common bile duct jejunum Roux-en-Y anastomosis.Conclusion Iatrogenic bile duct injury is a common and serious complication of cholecystectomy.We should choose how to treat it according to the situation and time after operation.
出处
《西部医学》
2011年第3期507-508,共2页
Medical Journal of West China
关键词
医源性
胆道损伤
原因
防治
Iatrogenic
Bile duct injury
Reason
Prevention
